EWARN Iraq

Case Definitions

Acute Upper Respiratory Infections

Any acute onset of fever, cough, runny nose, pharyngitis,

laryngitis, otitis, tonsillitis, with normal breathing and with or

without danger signs.

Acute Lower Respiratory Tract Infection (Suspected Pneumonia)

Children < 5 years: Any child presenting with cough and difficult

breathing with any one of these:

Fast breathing (Less than 2 months; > 60 breaths/min, 2 months to 12

months; >50 breath/min, 12 months to 5 years; > 40 breaths/min).

Lower chest wall in-drawing,

unable to drink or breastfeed,

difficulty to awaken,

fits / convulsions,

Stridor in calm child.

Over 5 years: Any person presenting with acute onset of cough, fever,

difficulty in breathing and chest pain which increases with breathing.

Acute Diarrhea (not cholera or bloody

diarrhoea )

Acute diarrhoea (passage of 3 or more loose stools in the past

24 hours) with or without dehydration, and which is not

bloody or watery diarrhea.

Acute Bloody Diarrhea

Person with acute diarrhoea characterized by presence of blood

and/or mucus in stool accompanied by fever.

Suspected Cholera

Person aged >5 years with acute watery diarrhoea with or without

vomiting. Or death due to Acute watery diarrhea and severe

dehydration

When there is confirmed cholera outbreak in the area then the case

definition will be: Any person with acute watery diarrhoea with or

without vomiting.

Acute Jaundice Syndrome (Acute

Hepatitis A or E)

Any person with acute onset of jaundice (yellow eyes or

skin, dark urine, nausea, vomiting, itching, loss of

appetite, fatigue, with or without fever) and absence of

any known precipitating factor.

Acute Flaccid Paralysis

Any child under 15 years of age with recent onset of floppy

weakness of limbs due to any cause,

OR

any person of any age with a paralytic illness, in whom

poliomyelitis is suspected clinically.

Suspected Measles

Any person with fever, and maculo-papular non vesicular

rash

OR

Any person in whom a clinician suspects measles infection

Suspected Meningococcal Meningitis

An illness with sudden onset of high grade fever and neck stiffness or

in patients under 18 months of age, suspect meningitis when fever is

accompanied by bulging fontanel; and one or more of the followings:

• Altered consciousness

• Other meningeal sign

• petechial or puerperal rash

Suspected Diphtheria

An upper respiratory tract illness characterized by , a thick

adherent gray coating called “pseudo-membrane” usually

developed within two to three days over the nasal tissues,

tonsils, voice box or throat.

Suspected Pertussis (Whooping Cough)

A person with a cough lasting at least 2 weeks with one of the

followings: Paroxysms i.e. bouts of coughing; or Inspiratory

"whoop" or Post-tussive vomiting (i.e. vomiting immediately after

coughing) AND without other apparent cause.

OR

A case diagnosed as pertussis by a physician.

Suspected Neonatal tetanus (NNT)

Any neonatal death between 3 and 28 days of age in which the

cause of death is unknown or any neonate reported as having

suffered from neonatal tetanus and not investigated.

OR

Any neonate with normal ability to suck and cry during the first

2 days of life but who between 3 and 28 days of age cannot

suck normally and becomes stiff or has convulsions or both.

Hospital-reported cases are considered confirmed.

Suspected Mumps

Any patient with fever and unilateral or bilateral tender

swelling of the parotid or other salivary gland without other

apparent cause

Suspected Leishmaniasis

Cutaneous:

Appearance of one or more skin lesions, typically on

uncovered parts of body (Face, Neck, Arms and Legs) which

begins as nodules and turn into skin ulcers eventually healing

but leaving a depressed Scar.

Visceral (Kala-Azar):

Case presenting with irregular fever, Hepato/Splenomegaly,

enlarged lymph nodes, weight loss, fatigue and secondary

infections such as Pneumonia,

Suspected Acute Hemorrhagic Fever

Patient with high grade fever and bleeding of one or more of

the following:(epistaxis, hematemesis, hemoptysis, melena,

sub-conjunctival hemorrhage)

Suspected Chickenpox

Any person with fever, and generalized vesicular rash

OR

Any person in whom a clinician suspects chickenpox

infection

Suspected Scabies

Skin infection characterized by rash or lesions and intense

itching especially at night. Lesions prominent around finger

webs, wrists, elbows, axillaries, beltlines, thighs, external

genitalia, nipples, abdomen and lower portion of buttocks.

Head, neck, palm and soles of infants may be involved.

Unusual Communicable Disease (name:

Two times or more increase in the number of any endemic

communicable disease or one suspected case of a disease

reported for the first time in the country